Predictors of In-Hospital Mortality Among Older Patients

OBJECTIVE: The objective of this study was to determine predictors of in-hospital mortality among older patients admitted to a geriatric care unit. INTRODUCTION: The growing number of older individuals among hospitalized patients demands a thorough investigation of the factors that contribute to their mortality. METHODS: This was a prospective observational study implemented from February 2004 to October 2007 in a tertiary university hospital. A consecutive sample of 922 patients was evaluated for possible inclusion in this study. Patients hospitalized for palliative care, those who declined to participate, and those with incomplete data were excluded, resulting in a group of 856 patients aged 60 to 104 years. Bivariate and multivariate analyses were performed to determine associations between in-patient mortality and gender, age, length of stay, number of prescribed medications and diagnoses at admission, history of heart failure, neoplastic disease, immobility syndrome, delirium, infectious disease, and laboratory tests at admission (serum albumin and creatinine). RESULTS: The overall mortality rate was 16.4%. The following factors were associated with higher in-hospital mortality: delirium (OR=4.13, CI=2.65-6.44, P<.001), neoplastic disease (OR=3.38, CI=2.11-5.42, P<.001), serum albumin levels at admission <3.3mg/ dL (OR=3.23, CI=2.03-5.13, P<.001), serum creatinine levels at admission >1.3mg/dL (OR=2.39, CI=1.53-3.72, P<.001), history of heart failure (OR=1.97, CI=1.20-3.22, P=.007), immobility (OR=1.84, CI=1.16-2.92, P =.009), and advanced age (OR=1.03, CI=1.01-1.06, P=.019). CONCLUSIONS: This study strengthens the perception of delirium as a mortality predictor among older inpatients. Cancer, immobility, low albumin levels, elevated creatinine levels, history of heart failure and advanced age were also related to higher mortality rates in this population

On Heavy-Quark Free Energies, Entropies, Polyakov Loop, and AdS/QCD

In this paper we explore some of the features of a heavy quark-antiquark pair at finite temperature using a five-dimensional framework nowadays known as AdS/QCD. We shall show that the resulting behavior is consistent with our qualitative expectations of thermal gauge theory. Some of the results are in good agreement with the lattice data that provides additional evidence for the validity of the proposed model.Comment: 15 pages, 10 figures; v2: comments added, misprints correcte

Determinação de ácidos orgânicos em plantas e alimentos da Amazônia. I - Ácidos orgânicos do Tucupi

Three types of Tucupi were analyzed by gas-Phase Chromatography. The following acids wore found: acetic, propionic, palmitic and oleic, in the yellow, white and macaxeira types; butiric and valeric in yellow type; and succinic in the yellow and white types.Três tipos de Tucupi foram analisados por Cromatografia em fase gasosa. Constatou-se a presença dos ácidosacético, propiônico, palmítico e oléico nos tipos amarelo, branco e de macaxeira; dos ácidos butírico e valérico no tipo amarelo, enquanto que o ácido succínico foi detectado nos tipos amarelo e branco

Interplay of quantum and classical fluctuations near quantum critical points

For a system near a quantum critical point (QCP), above its lower critical dimension $d_L$, there is in general a critical line of second order phase transitions that separates the broken symmetry phase at finite temperatures from the disordered phase. The phase transitions along this line are governed by thermal critical exponents that are different from those associated with the quantum critical point. We point out that, if the effective dimension of the QCP, $d_{eff}=d+z$ ($d$ is the Euclidean dimension of the system and $z$ the dynamic quantum critical exponent) is above its upper critical dimension $d_C$, there is an intermingle of classical (thermal) and quantum critical fluctuations near the QCP. This is due to the breakdown of the generalized scaling relation $\psi=\nu z$ between the shift exponent $\psi$ of the critical line and the crossover exponent $\nu z$, for $d+z>d_C$ by a \textit{dangerous irrelevant interaction}. This phenomenon has clear experimental consequences, like the suppression of the amplitude of classical critical fluctuations near the line of finite temperature phase transitions as the critical temperature is reduced approaching the QCP.Comment: 10 pages, 6 figures, to be published in Brazilian Journal of Physic

Estudo químico de óleos essenciais, oleaginosas e látices da Amazônia. I. Composição e oxidação do óleo de uma espécie de Copaifera (Nota prévia).

Preliminar note on a study of the resta oil (from the trunk) and the seed oil from a species of Copaifera was done, using the analytical methods known as GC/MS and HPLC and the volumetric method. This work was developed at the Divisão de Química of the INPA in collaboration with the Departamento de Química of the UPCe with the purpose to identify the chemical components and to establish the kinetic control of auto oxidation with and without the addition of antioxidants and synergistic agents

Turbulent flow at 190 m height above London during 2006-2008: A climatology and the applicability of similarity theory

Flow and turbulence above urban terrain is more complex than above rural terrain, due to the different momentum and heat transfer characteristics that are affected by the presence of buildings (e.g. pressure variations around buildings). The applicability of similarity theory (as developed over rural terrain) is tested using observations of flow from a sonic anemometer located at 190.3 m height in London, U.K. using about 6500 h of data. Turbulence statistics—dimensionless wind speed and temperature, standard deviations and correlation coefficients for momentum and heat transfer—were analysed in three ways. First, turbulence statistics were plotted as a function only of a local stability parameter z/Λ (where Λ is the local Obukhov length and z is the height above ground); the σ_i/u_* values (i = u, v, w) for neutral conditions are 2.3, 1.85 and 1.35 respectively, similar to canonical values. Second, analysis of urban mixed-layer formulations during daytime convective conditions over London was undertaken, showing that atmospheric turbulence at high altitude over large cities might not behave dissimilarly from that over rural terrain. Third, correlation coefficients for heat and momentum were analyzed with respect to local stability. The results give confidence in using the framework of local similarity for turbulence measured over London, and perhaps other cities. However, the following caveats for our data are worth noting: (i) the terrain is reasonably flat, (ii) building heights vary little over a large area, and (iii) the sensor height is above the mean roughness sublayer depth

Sensitization to inhalant and food allergens in Brazilian atopic children by in vitro total and specific IgE assay: Allergy Project - PROAL

OBJECTIVE: To determine the frequency of sensitization to inhalant and food allergens in children seen at Brazilian allergy services. PATIENTS AND METHODS: Total and specific IgE serum levels to inhalant and food allergens (RAST, UniCAP® - Pharmacia) were measured in 457 children accompanied in pediatric allergy services and in 62 control children age matched. RAST equal or higher than class 1 was considered as positive (R+). RESULTS: Frequency of R+ was significantly higher among atopics (361/457, 79%) when compared to controls (16/62, 25.8%). There were no differences according to gender. The frequency of R+ to all allergens evaluated were higher among atopics when compared to controls. Significantly higher total IgE serum levels were observed among the atopics with R+ in comparison to those with R-. The frequency of R+ to main inhalant allergens were: D. pteronyssinus = 66.7% x 14.5% (p < 0.05), D. farinae = 64.5% x 17.8% (p < 0.05), B. tropicalis = 55.2% x 19.4% (p < 0.05), cockroach = 32.8% x 9.7% (p < 0.05), and cat = 12% x 8.1%. In relation to food allergens we observed: fish = 29.5% x 11.3% (p < 0.05), egg = 24.4% x 4.8% (p < 0.05), cow's milk = 23.1% x 3.2% (p < 0.05), wheat = 20% x 8.1% (p < 0.05), peanuts = 14% x 4.8% (p < 0.05), soy = 11.8% x 4.8% (p < 0.05), and corn = 10.6% x 4.8% (p < 0.05). With respect of age, food allergen sensitization predominates in young children whereas the inverse occurs with inhalant allergens. CONCLUSIONS: There was a predominant frequency of sensitization to inhalant allergens, mainly house dust mites in the evaluated patients. Food allergens were also responsible for a significant proportion of sensitization, mainly in infants.OBJETIVO: Determinar a freqüência de sensibilização a alérgenos inalantes e alimentares em crianças atendidas em serviços brasileiros de alergia. PACIENTES E MÉTODOS: IgE sérica total e específica (RAST) a alérgenos inalantes e alimentares (UniCAP® - Pharmacia) foram determinados em 457 crianças acompanhadas em serviços de alergia pediátrica e em um grupo de controles (n = 62). Resultados classe igual ou maior que 1 foram considerados positivos (R+). RESULTADOS: A freqüência de R+ foi significantemente maior entre os atópicos (361/457, 79%) quando comparados aos controles (16/62, 25,8%). Não houve diferenças quanto ao sexo. A prevalência de R+ entre os atópicos foi significantemente maior para todos os alérgenos avaliados. Os níveis séricos de IgE total foram significantemente mais elevados entre os atópicos com R+ quando comparados aos com R-. Comparando-se atópicos e controles, a freqüência de R+ para os principais alérgenos inalantes foi como segue: D. pteronyssinus = 66,7 versus 14,5% (p < 0,05), D. farinae = 64,5 versus 17,8% (p < 0,05), B. tropicalis = 55,2 versus 19,4% (p < 0,05), barata = 32,8 versus 9,7% (p < 0,05) e gato = 12 versus 8,1%. Com os alimentos, observou-se: peixe = 29,5 versus 11,3% (p < 0,05), ovo = 24,4 versus 4,8% (p < 0,05), leite de vaca = 23,1 versus 3,2% (p < 0,05), trigo = 20 versus 8,1% (p < 0,05), amendoim = 14 versus 4,8% (p < 0,05), soja = 11,8 versus 4,8% (p < 0,05) e milho = 10,6 versus 4,8% (p < 0,05). Segundo a idade, os R+ aos alimentares predominaram entre as crianças mais jovens, e o inverso ocorreu com os inalantes. CONCLUSÕES: Nesta população, predominou a sensibilização aos aeroalérgenos, sobretudo aos ácaros domiciliares, e os alimentos foram importantes em crianças mais jovens.Universidade Federal de São Paulo (UNIFESP) Departamento de Pediatria Disciplina de Alergia e Imunologia Clínica e ReumatologiaUniversidade Federal de São Paulo (UNIFESP)Grupo PROALUNIFESP, Depto. de Pediatria Disciplina de Alergia e Imunologia Clínica e ReumatologiaUNIFESPSciEL

Radio Sources in Low-Luminosity Active Galactic Nuclei. III. "AGNs" in a Distance-Limited Sample of "LLAGNs"

(abbreviated): This paper presents the results of a high resolution radio imaging survey of all known (96) low-luminosity active galactic nuclei (LLAGNs) at D<19Mpc. We find that almost half of all LINERs and low-luminosity Seyferts have flat-spectrum radio cores when observed at 150mas resolution. Higher (2mas) resolution observations of a flux-limited subsample have provided a 100% (16 of 16) detection rate of pc-scale radio cores, with implied brightness temperatures > 10^8 K. The five LLAGNs with the highest core radio fluxes also have pc-scale `jets.' Compact radio cores are almost exclusively found in massive ellipticals and in type1 nuclei. The core radio power is correlated with the nuclear optical `broad' Halpha luminosity, the nuclear optical `narrow' emission line luminosity and width, and with the galaxy luminosity. In these correlations LLAGNs fall close to the low-luminosity extrapolations of more powerful AGNs. About half of all LLAGNs with multiple epoch data show significant inter-year radio variability. Investigation of a sample of ~150 nearby bright galaxies, most of them LLAGNs, shows that the nuclear (<150mas size) radio power is strongly correlated with both the black hole mass and the galaxy bulge luminosity; linear regression fits to all ~150 galaxies give: log P(2cm) = 1.31 log M_blackhole + 8.77 and log P(2cm) = 1.89 log L_B(bulge) - 0.17. Low accretion rates are implied in both advection- and jet-type models. In brief, all evidence points towards the presence of accreting massive black holes in a large fraction, perhaps all, of LLAGNs.Comment: to appear in A&

Cool Roofs: High Tech Low Cost solution for energy efficiency and thermal comfort in low rise low income houses in high solar radiation countries

Cool roofs are most effective in reducing cooling loads and alleviating overheating in locations with high solar radiation and external air temperature. This paper presents results of an experimental study of a low income house in Jamaica and a computational study in three countries around the equator: Jamaica, Northeast Brazil (Recife) and Ghana. A case-study typical of single storey houses in Jamaica was monitored before and after the installation of a cool paint on the roof; on days with average solar radiation intensity of ∼420 W/m2 and ambient air temperature of ∼28 °C, internal ceiling surface temperature is reduced by an average of 6.8 °C and internal air temperature by 2.3 °C. Monitoring results were used to calibrate successfully an EnergyPlus model; similar models were developed for Ghana and Brazil differing in size and/or construction to reflect country specific practices. Annual simulations indicate that internal ceiling surface temperatures are reduced on average by 3.2–5.5 oC and internal air temperatures by 0.75–1.2 °C. Cooling demand simulations (setpoint 24 °C) indicate similar annual potential savings in the three locations (∼190 kWh/m2/year) although estimated CO2 emissions reduction differ reflecting electricity generation fuels. Aging of the cool roof has an impact reducing load savings by 22–26 kWh/m2/year.This work was carried out as part of EPSRC Global Challenges Research Fund Institutional Sponsorship Award 2016 - Brunel Uni- versity ( EP/P510749/1 )